C6 Neurologic Level: (C5-C6 disk)

- Radiculopathy:
- pts with a C6 radiculopathy should cause pain in the neck, shoulder, lateral arm, radial forearm, dorsum of hand, and tips of thumb, index, and long finger;
- distribution of pain is less extensive and more proximal, whereas paresthesia's predominate distally;
- in some individuals, a C6 lesion will manifest as a depressed or absent biceps reflex;
- in others, an abnormal brachioradialis or wrist extensor reflex can be found;
- C6 root lesions should be distinguished from lesions of brachial plexus;
- elbow flexion will be weak, and the patient will be unable to supinate the forearm against resistance with the elbow held in extension;

- C6 Quadriplegic Considerations: (care of the spine injured patient)
- pts w/ C-6 functional level can become independent because wrist extensor muscle function is still intact.
- pts may engage in independent living and perform independent sliding board transfers from bed to chair
and will be able to propel a manual wheelchair w/ quadriplegic pegs on wheel rim;
- pts should be able to perform self hygiene and feeding;
- in C6 lesions, radial wrist extension & varying degrees of triceps (C6-8) function is preserved;
- major concern in these patients is prevention of flexion contractures at elbow to the unopposed action of the flexor muscles;
- steindler flexorplasty :
- w/ C6 level paralysis brachioradialis & the ECRB / ECRL are only muscles functioning at the forearm and wrist;
- consider transfer of ECRL to FDP & BR to FPL ;
- consider transfer of biceps to olecranon process inorder to assist extension of the elbow;
- splints for C6 level;
- pts require a wrist driven flexor hinge hand splint for prehension;
- splints for C-6 escape:
- proximal stability present;
- loss of grasp
- good candidate for flexor hinge hand splint;
- ref: The Influence of Elbow Position on the Range of Motion of the Wrist Following Transfer of the Brachioradialis to the Extensor Carpi Radialis Brevis Tendon.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, December 8, 2011 12:48 pm

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Orthopaedics and the US Military

Text Author

Dr. Wheeless enjoys and performs all types of orthopaedic surgery but is renowned for his expertise in total joint arthroplasty (Hip and Knee replacement) as well as complex joint infections. He founded Orthopaedic Specialists of North Carolina in 2001 and practices at Franklin Regional Medical Center and Duke Raleigh Hospital.